Challenges to implementation of the new Coroners' (Amendment) Rules 2005: experience from a tertiary paediatric pathology centre.

In the UK sudden unexpected childhood deaths are referred to Her Majesty's Coroner (HMC) for postmortem examination during which small tissue samples are obtained for diagnostic purposes. Recent changes to regulate tissue use include the Coroners' (Amendment) Rules 2005. We audited the impact of these at a specialist paediatric centre. A retrospective audit of HMC tissue forms for autopsies was performed between 1 June 2005 - 31 May 2006, with regard to the options provided to, and chosen by, parents. Of 213 coronial autopsies, 178 were non-forensic. Tissue forms were submitted pre-autopsy in 25 (14%). An additional 47 were received after sending follow-up letters for a total of 72/178 (40%). Forms varied between coroners, but most failed to distinguish between blocks, slides, and other tissue samples and 6/40 (15%) forms did not specifically allow an option for research consent. Forty-three (60%) parents opted for retention, with 34 (79%) also consenting to research. Only six (8%) requested return of tissue. A simple, unified tissue disposal form and information sheet for all HMC districts, which includes appropriate options, would ensure that parents' wishes are met, to achieve best practice, maximise sample availability for positive societal outcomes such as teaching and research, and to comply with new regulations.